2807309
Commonweath of Virginia
Department of Health - Division of Vital Records

Department of Commerce
Bureau of the Census

Certificate of Death
Commonwealth of Virginia
Department of Health
Bureau of Vital Statistics

State File No. 5481
Registered No. 708

1. Place of Death
(a) County
Regstration district No.
(b) Magisterial district
(c) City or Town: Richmond
(d) Name of hospital or institution: M.C.
(e) Length of stay in hosp. or inst.: 7 days
(f) Is place of death withing corporate limits?

2. Usual Residence of Deceased
(a) State: Va
(b) County
(c) City or town: Richmond Street No.: 1612 Confederate Av.
(d) Is place of residence within corpoarte limits?
(e) Citizen of foreigh country? (Yes or No)
If Yes, name country

3. (a) Full Name: Annie Catherine Greenwood [93 superscript-D appears in lighter pen next to name]
3. (b) If veteran, name war 3. (c) Social security number
4. Sex: Female
5. Color or race: White
6. (a) Single, married, widowed or divorced: Wd-
6. (b) name of husband or wife
7. Date of birth of deceased: May 11, 1861 [crossed out] 1862
8. Age: Years: 82
9. Birthplace: Kent Co., Md.
10. Usual occupation: Housewife
11. Industry or business

Father
12. Name: (Don't Know) West
13. Birthplace: Don't Know
Mother
14. Maiden name: Don't Know
15. Birthplace: Don't Know

18. (a) Informant's own signature: Karl F. Frederick
(b) Address: 1612 Confederate Ave.

17. (a) Burial, cremation or removal? Removal
(b) Place: Wilmington, Del. Date: March 21, 1945
18. (a) Signature of funeral director: J. W. Biley
(b) Address: Richmond, Virg.
19. (a) Filed: 3-20, 1945
(b) A.J. Borouslu

20. Date of Death: March 20, 1945 11:00 a.m.
21. I hereby certify that I attended the deceased from March 13, 1945 to Mar. 20, 1945; that I last saw her alive on Mar. 20, 1945 and that death occurred on the date and hour stated above.
Immediate cause of death: Coronary oclusion
Duration:
Due to: Arteriosclerostic heart disease
Due to
Other conditions: [093D is writting in lighter pen here. May be code for cause of death?]
Name of operations:
Date of operation:
Magor findings: (a) of operations
(b) of autopsy.
Physician: Underline the primary cuase to which death should be charged statistically. 1- [also in the lighter pen]

22. If death was due to external causes fill in the following:
(a) Accident, suicide, or homicide (specify):
(b) Date of occurance:
(c) Where did injury occur?
(d) Did injury occur in or about home, on farm, in industrial place, in public place?
While at work?
(e) Means of injury

23. Signature: A. G Gorbright Jr.
Address: Med. College of Va. Hosp.
Date Signed: 3/20/45